The Care Quality Commission
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  • GP practice

Archived: The Good Practice

Overall: Requires improvement read more about inspection ratings

409 Kings Road, Chelsea, London, SW10 0LR (020) 7351 1766

Provided and run by:
The Good Practice

All Inspections

18 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Good Practice on 18 May 2016. Overall the practice is rated as requires improvement.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were not adequately assessed for example the practice did not have oxygen or a defibrillator available for use in an emergency and had not assessed the risks of this.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it difficult to make an appointment and there were limited urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a leadership structure and staff felt supported by management.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

  • Ensure patient specific prescription or direction from a prescriber are in place in accordance with legislation to support the Health Care Assistant with the safe administration of vaccines and medicines.
  • The practice should ensure an automated external defibrillator (used to attempt to restart a person’s heart in an emergency) and oxygen are available or should carry out a risk assessment to identify what action would be taken in an emergency.
  • Implement processes to continually assess risks to patients and staff, such as carry out an infection control audit and fire drills. 

The areas where the provider should make improvement are:

  • Review the telephone and booking system to ensure that patients are able to book appointments when needed.
  • Review the practice’s opening hours in light of patient feedback in the GP patient survey
  • Review their exception reporting in relation to the Quality and Outcomes Framework (QOF) with the aim of reducing it. Implement processes to improve the uptake for the cervical screening programme.
  • Document the practice vision and ensure the practice strategy and supporting business plans reflect it.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

14 May 2014

During a routine inspection

The Good Practice is located in Kings Road, and provides GP primary care services to people living in the south of the borough of Kensington and Chelsea. It has just over 3000 patients registered. There are two partners – a male and a female. They are registered to provide diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.

During our visit, which took place over one day, we spoke with the GPs, the practice manager, health care assistant (HCA) and administrative staff. We spoke with five patients and a representative of the practice’s patient participation group (PPG). Ten patients completed comments cards telling us what they thought of the care they have received from the service.

All the patients we spoke with during the inspection told us they were satisfied with the quality of care and support offered by the surgery. The practice was clean and hygienic and systems were in place to manage medicines safely.

The practice was caring, however some improvements were needed. Patients described the staff as sympathetic, patient and understanding. However, they expressed concern that it was very difficult to contact the surgery by phone to book an appointment and that this situation has been ongoing for some time.

Improvements were required to ensure the practice provides safe patient care. There were appropriate safeguarding policies and procedures in place. However, we found that staff had not attended safeguarding of vulnerable adults training. Further, whilst the practice had an infection control team, there was no one identified as the infection control lead and there was no up to date infection control audit.

The GP’s used National Institutes for Health and Care Excellence (NICE) guidelines and their clinical knowledge summaries (CKS) which provides primary care practitioners with a readily accessible summary of the current evidence base and practical guidance on best practice. However, as the practice did not have any systems in place to monitor or asses the care they were providing, they were unable to demonstrate how they were improving outcomes for their patients.

Improvements were required to ensure the practice is more responsive to people’s needs. We found the practice was accessible for people with mobility difficulties, patients were referred for tests or specialist consultations in a timely way. However, the practice did not employ a nurse which meant that minor treatments had to be carried out at the local walk-in centre.

Improvements were required to ensure the practice was well led in all areas. The leadership team promoted a supportive open culture, there were systems in place for identifying and managing risk and there were opportunities for staff development. However there were no formal processes in place to gather feedback from patients and staff.